Patients with Alzheimer's & Dementia
Having a general daily routine in Alzheimer’s and dementia care helps caregiving run smoothly. These routines are set in stone in order to give a sense of consistency, which is beneficial to the Alzheimer’s patient even if they can’t communicate it. Our facilities provide for daily hygiene routines, dressing and grooming assistance. We ensure urgent ambulation and transfer assistance should any medical emergencies arise. Daily housekeeping and a personal laundry service is also provided.
Three delicious, nutritional meals as well as in-between-snacks are given daily. Doctor prescribed special diets are also accommodated. A Hospice Care Program for End of Life Care is also available for patients too frail to support themselves. Medication is managed and monitored at all times to ensure that the patient maintains their health.
We provide a homely, loving environment where the resident can feel comfortable and accepted. We practice patience and consideration through building a level of trust and companionship.
Music therapy plays an integral part in our care giving as scientific studies have proven that major improvements in cognitive and memory recognition. We are firm believers that music is the key to the soul, no matter what your age, denomination or stature.
Patients with Strokes
A stroke, also known as a cerebrovascular attack (CVA), is the rapid loss of brain function(s) due to disturbance in the blood supply to the brain.
This can be due to ischemia (lack of blood flow) caused by blockage (thrombosis, arterial embolism), or a hemorrhage (leakage of blood). As a result, the affected area of the brain cannot function, which might result in an inability to move one or more limbs on one side of the body, inability to understand or formulate speech, or an inability to see one side of the visual field.
A stroke is a medical emergency and can cause permanent neurological damage, complications, and death. It is the leading cause of adult disability in the United States and Europe and the second leading cause of death worldwide] Risk factors for stroke include old age, hypertension (high blood pressure), previous stroke or transient ischemic attack (TIA), diabetes, high cholesterol, cigarette smoking and arterial fibrillation. High blood pressure is the most important modifiable risk factor of stroke.
A silent stroke is a stroke that does not have any outward symptoms, and the patients are typically unaware they have suffered a stroke. Despite not causing identifiable symptoms, a silent stroke still causes damage to the brain, and places the patient at increased risk for both transient ischemic attack and major stroke in the future. Conversely, those who have suffered a major stroke are at risk of having silent strokes. Silent strokes typically cause lesions which are detected via the use of neuroimaging such as MRI. Silent strokes are estimated to occur at five times the rate of symptomatic strokes. The risk of silent stroke increases with age.
An ischemic stroke is occasionally treated in a hospital with thrombolysis (also known as a “clot buster”), and some hemorrhagic strokes benefit from neurosurgery. Treatment to recover any lost function is termed stroke rehabilitation, ideally in a stroke unit and involving health professions such as speech and language therapy, physical therapy and occupational therapy. Prevention of recurrence may involve the administration of antiplatelet drugs such as aspirin and dipyridamole, control and reduction of hypertension, and the use of statins. Selected patients may benefit from carotid endarterectomy and the use of anticoagulants.
This necessitates special care in the retirement and frail care arena. Many patients are movement and speech impaired and special care is necessitated such as assistance with daily activities like ablution functions, feeding, dressing, general moving about etc . This is intensive assistance.
Stroke rehabilitation is the process by which patients with disabling strokes undergo treatment to help them return to normal life as much as possible by regaining and relearning the skills of everyday living. It also aims to help the survivor understand and adapt to difficulties, prevent secondary complications and educate family members to play a supporting role.
A rehabilitation team is usually multidisciplinary as it involves staff with different skills working together to help the patient. AD Care Group will facilitate this role in assembling the various skilled HSP. These include nursing staff, physiotherapy, occupational therapy, speech and language therapy, and usually a physician trained in rehabilitation medicine. Some teams may also include psychologists, social workers, and pharmacists since at least one third of the patients manifest post stroke depression. Validated instruments such as the Barthel scale may be used to assess the likelihood of a stroke patient being able to manage at home with or without support subsequent to discharge from hospital.
Good nursing care is fundamental in maintaining skin care, feeding, hydration, positioning, and monitoring vital signs such as temperature, pulse, and blood pressure. Stroke rehabilitation begins almost immediately. For most stroke patients, physical therapy (PT), occupational therapy (OT) and speech-language pathology (SLP) are the cornerstones of the rehabilitation process. Often, assistive technology such as a wheelchair, walkers, canes, and orthosis may be beneficial. PT and OT have overlapping areas of working but their main attention fields are; PT focuses on joint range of motion and strength by performing exercises and re-learning functional tasks such as bed mobility, transferring, walking and other gross motor functions. Physiotherapists can also work with patients to improve awareness and use of the hemiplegic side. Rehabilitation involves working on the ability to produce strong movements or the ability to perform tasks using normal patterns. Emphasis is often concentrated on functional tasks and patient’s goals. One example physiotherapists employ to promote motor learning involves constraint-induced movement therapy. Through continuous practice the patient relearns to use and adapt the hemiplegic limb during functional activities to create lasting permanent changes. OT is involved in training to help relearn everyday activities known as the Activities of daily living (ADLs) such as eating, drinking, dressing, bathing, cooking, reading and writing, and toileting. Speech and language therapy is appropriate for patients with the speech production disorders, cognitive-communication impairments and/or problems with swallowing.
Patients may have particular problems, such as dysphagia, which can cause swallowed material to pass into the lungs and cause aspiration pneumonia. The condition may improve with time, but in the interim, a gastric tube may be inserted, enabling liquid food to be given directly into the stomach. If swallowing is still deemed unsafe, then a percutaneous endoscopic gastrostomy (PEG) tube is passed and this can remain indefinitely. These procedures are of a specialist nature and AD Care will only facilitate the employ of specialist health care professionals to perform this at an additional cost to the patient.
Treatment of spasticity related to stroke often involves early mobilisations, commonly performed by a physiotherapist, combined with elongation of spastic muscles and sustained stretching through various positioning. Gaining initial improvements in range of motion is often achieved through rhythmic rotational patterns associated with the affected limb. After full range has been achieved by the therapist, the limb should be positioned in the lengthened positions to prevent against further contractures, skin breakdown, and disuse of the limb with the use of splints or other tools to stabilize the joint. Cold in the form of ice wraps or ice packs have been proven to briefly reduce spasticity by temporarily dampening neural firing rates. Electrical stimulation to the antagonist muscles or vibrations has also been used with some success.
Stroke rehabilitation should be started as quickly as possible and can last anywhere from a few days to over a year. Most return of function is seen in the first few months, and then improvement falls off with the “window” considered officially by U.S. state rehabilitation units and others to be closed after six months, with little chance of further improvement. However, patients have been known to continue to improve for years, regaining and strengthening abilities like writing, walking, running, and talking. Daily rehabilitation exercises should continue to be part of the stroke patient’s routine. Complete recovery is unusual but not impossible and most patients will improve to some extent: proper diet and exercise are known to help the brain to recover.
Some current and future therapy methods include the use of virtual reality and video games for rehabilitation. These forms of rehabilitation offer potential for motivating patients to perform specific therapy tasks that many other forms do not. Many clinics and hospitals are adopting the use of these off-the-shelf devices for exercise, social interaction and rehabilitation because they are affordable, accessible and can be used within the clinic and home. Most of the above procedures are of a specialist nature and AD Care will only facilitate the employ of specialist health care professionals to perform this at an additional cost to the patient.
Patients with Motor Neuron Disease
The motor neurone diseases (MND) or motor neuron diseases are a group of neurological disorders that selectively affect motor neurones the cells that control voluntary muscle activity including speaking, walking, breathing, swallowing and general movement of the body. They are generally progressive in nature, and can cause progressive disability and death.
This once again impairs mobility, speech and general quality of life and assistance revolves around ablution functions, feeding, dressing, general moving about and is also very intensive. The lack of effective medications to slow the progression of ALS does not mean that patients with ALS cannot be medically cared for. Instead, treatment of patients with ALS focuses on the relief of symptoms associated with the disease. This involves a variety of health professionals including neurologists, speech-language pathologists, physical therapists, occupational therapists, dieticians, respiratory therapists, social workers, palliative care specialists, specialist nurses and psychologists.
Patients with Cancer
Cancer known medically as a malignant neoplasm, is a broad group of various diseases, all involving unregulated cell growth.
In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the body through the lymphatic system or bloodstream. Not all tumors are cancerous. Benign tumors do not grow uncontrollably, do not invade neighboring tissues, and do not spread throughout the body.
Determining what causes cancer is complex. Many things are known to increase the risk of cancer, including tobacco use, certain infections, radiation, lack of physical activity, poor diet and obesity, and environmental pollutants. These can directly damage genes or combine with existing genetic faults within cells to cause the disease. Approximately five to ten percent of cancers are entirely hereditary.
Cancer can be detected in a number of ways, including the presence of certain signs and symptoms, screening tests, or medical imaging. Once a possible cancer is detected it is diagnosed by microscopic examination of a tissue sample. Cancer is usually treated with chemotherapy, radiation therapy and surgery. The chances of surviving the disease vary greatly by the type and location of the cancer and the extent of disease at the start of treatment. While cancer can affect people of all ages, and a few types of cancer are more common in children, the risk of developing cancer generally increases with age.
Palliative care is an approach to symptom management that aims to reduce the physical, emotional, spiritual, and psycho-social distress experienced by people with cancer. Unlike treatment that is aimed at directly killing cancer cells, the primary goal of palliative care is to make the person feel better.
Palliative care is often confused with hospice and therefore only involved when people approach end of life. Like hospice care, palliative care attempts to help the person cope with the immediate needs and to increase the person’s comfort. Unlike hospice care, palliative care does not require people to stop treatment aimed at prolonging their lives or curing the cancer.
Early palliative care is recommended for people whose cancer has produced distressing symptoms (pain, shortness of breath, fatigue, nausea) or who need help coping with their illness. The AD Care Group facilitates the process, also involving the family where it is imperative that they are also advised as to the knock- on psychological effects and physical demands that cancer causes not only to the patient, but also the family and carers.
Patients in Wheelchairs
As general ageing and most of the above symptoms result into loss of mobility, most of our patients need assistance with movement. We assist them with general day to day tasks and movement is enhanced by the use of wheel chairs and zimmer frames.
Special care must be given to accommodate free movement and easy access to wheel chairs and zimmer frames.
The installation of grab bars, powered doors, special paddle tap handles etc are required to assist users.
When illness forces us to bed and limits our activities, the body revolts. Muscles stiffen and contract, skin breaks down and forms wounds known as, bed sores and our lungs get wetter and less able to breathe effectively. Sometimes small blood clots form in our blood vessels and can cause severe complications. Even the fluffiest, most comfy mattress in the world becomes a most uncomfortable prison if you can never escape from it.
Simple things caregivers can do to provide relief and to enhance the quality of life of your bed bound client:
- Changing the patient’s position frequently relieves pressure on backs, buttocks and hips. If possible, raising the head of the bed can assist the patient at meal times, when taking medications or with breathing. If the patient has good upper body strength, a bed “trapeze” lets the client use her/his upper arm strength to help with repositioning.
- Get at least 4 pillows, include one of those long body pillows since you can and place them between the knees, ankles, under the arms and behind the back when the patient is laid on her side.
- Always use a draw sheet and place it under the hips and buttocks of the client. NOT behind their back. You can use folded sheets but commercially sold water-proof pads are strong enough to support the client. Use these pads and not the client’s arms and legs to re-position them in bed. Clients should be turned every 2 hours to prevent bed sores, and yes, bed sores can occur in just a few hours.
- Perform daily or twice daily skin checks. Pay close attention to the skin on the back of the ears, buttocks, heels and back.
- Avoid electric blankets or heating pads. Some patients have compromised vascular status and these blankets quickly become warm enough to burn.
- Heel protectors provide essential protection to the skin of the heels, a common site of bed sores.
- Position the patient’s bottom above the middle of the bed and keep the foot of the bed slightly elevated. Positioning the bed this way helps keep the patient from scrunching down in the bed.
Giving a Complete Bed Bath:
- It is good idea to provide the bed-bound patient with a bath each day. This provides cleanliness, helps prevent skin breakdown and helps to refresh the patent in both body and spirit. A large bowl filled with warm water may be used or a no-rinse shampoo and body wash that does not require rinsing. To avoid chilling the patient, only a small area should be bathed at a time. Gently soap the skin, then rinse and dry. Begin washing at the face and work down towards the feet. Don’t forget to wash the back. Apply a lotion containing lanolin. After washing the feet, the water will need to be changed before doing the buttocks area.
- Daily washing of the genital area is especially important since bacteria tend to collect there. Wash between the patient’s legs from the front toward the back. Rinse well and dry gently with a towel. Apply a soothing, moisture retarding ointment to apply to this area if control of stool or urine is a problem.
Good practice for body cleaning:
- If movement causes pain, wait about one hour after giving pain medication to bath them.
- Ask the patient if you are rubbing too hard or too lightly. Everyone has a different sense of touch.
- Provide privacy for the patient during the bath. If the patient is in a hospital bed, raise or lower the bed to lessen the strain on your back.
- This is a good time to brush and style hair, and shave the patient. For some patients, attention to their accustomed personal habits will help lighten their spirits and maintain their dignity.